Procedure
A neck dissection is performed under general anesthesia. The incision can vary depending on the aim of the operation and is selected by the surgeon. During the neck dissection, important anatomical structures are first visited to gain an overview and not to injure important organs or vessels.
Subsequently, the lymph nodes closest to the actual tumour are examined. The resected lymph nodes are usually sent to the pathology department during the operation to be examined under the microscope. This procedure is also called frozen section.
The pathologists examine whether there are tumour cells in the lymph nodes and if so, how far they are located at the edge of the incision. The frozen section has diagnostic reasons and is also decisive for the further course of the operation. If all endangered or abnormal lymph nodes and surrounding structures have been successfully removed, the operation can be terminated. Unfortunately, it also happens that affected lymph nodes or vessels could not be removed for surgical reasons and the operation must be terminated prematurely.
Complications
Complications of a neck dissection are on the one hand the general surgical risks as well as the specific complications of a neck dissection. The general risks include general anesthesia and the risk of injury to important organs, nerves and vessels, as well as bleeding, inflammation, excessive scarring, wound healing disorders and postoperative bleeding. The specific complications of a neck dissection depend on the radical nature of the procedure.
Thus, therapeutic neck dissection is associated with a significantly higher rate of complications than elective or selective neck dissection. Whether the resection is unilateral or bilateral also plays a major role in the surgical risk and side effects. In particular, the removal of important structures such as larger nerves, muscles and blood vessels increases the risk of complications. Therapeutic dissection is particularly affected by this, as the great jugular vein (vena jugularis interna), a great cranial nerve (nervus accessorius) and the sternocleidomastoid muscle (musculus sternocleidomastoideus) are removed.
Will there be scars?
Whether scars remain depends on the respective incision of the surgeon. This can vary greatly depending on the aim of the operation. The surgeon will usually orientate himself on anatomical structures and skin folds, so that a good cosmetic result is possible later.
In addition, a special suturing technique (intracutaneous suture) is usually used in neck operations to make the scar as inconspicuous as possible. This will make the scar appear very slit-shaped. In order to achieve the best possible aesthetic result, the scar should be treated with creams after it has healed. Early and frequent movement of the neck can enlarge the scar.
Lymph drainage
The lymphatic system extends over the entire body and absorbs fluid from the tissue to drain it back into the blood via lymph vessels. Lymph nodes are a kind of intermediate station that filter the lymph and stop harmful cells. They are therefore part of the immune system.
During the resection of lymph vessels and nodes (lymphadenectomy), the lymph may subsequently be unable to drain and accumulate in the tissue. This event is also called lymphedema. Therapeutic support can be provided by massage or manual lymphatic drainage, which promotes drainage and counteracts the swelling.
